Comparison of clinical features and outcomes of patients hospitalized with heart failure and normal ejection fraction (≥55%) versus those with mildly reduced (40% to 55%) and moderately to severely reduced (<40%) fractions
Comparison of clinical features and outcomes of patients hospitalized with heart failure and normal ejection fraction (≥55%) versus those with mildly reduced (40% to 55%) and moderately to severely reduced (<40%) fractions
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DOI：
10.1016/j.amjcard.2007.12.014
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发表时间：
2008-04-15
影响因子：
2.8
通讯作者：
Stevenson, Lynne W.
中科院分区：
文献类型：
--
作者：
Sweitzer, Nancy K.;Lopatin, Margarita;Stevenson, Lynne W.
射血分数（EF）正常的心力衰竭（HF）是急性失代偿性HF越来越常见的表现。HF和真正正常EF患者与轻度EF受损患者之间的差异尚未得到描述。急性失代偿性心力衰竭登记（ADHERE）包含> 100，000例HF住院治疗的信息，并可能提供对这种区别的见解。ADHERE数据库用于研究因HF和重度（≥ 55%）住院患者之间的差异。EF正常组中69%的女性平均年龄为74岁（p = 55%），脉压增加，提示动脉硬化的作用。治疗因EF而异。与HF和EF严重降低组相比，HF和EF正常组肌酐升高>= 0.5 mg/dl的情况更常见。住院死亡率和在重症监护室的住院时间与EF成反比;总住院时间相似。总之，HF和EF正常的患者更可能是女性，有高脉压高血压史，冠状动脉疾病较少，住院死亡风险较低，但住院期间肾功能恶化的可能性较高。这些观察结果可能是未来临床试验设计中的重要考虑因素。(C)2008年爱思唯尔公司All rights reserved.
Heart failure (HF) with normal ejection fraction (EF) is an increasingly common presentation of acute decompensated HF. Differences between patients with HF and truly normal EF and those with mildly impaired EF have not been described. The Acute Decompensated Heart Failure Registry (ADHERE) contains information on > 100,000 HF hospitalizations and may provide insight into this distinction. The ADHERE database was used to investigate differences between patients hospitalized with HF and severely (= 55%). The group with normal EF was 69% women with a mean age of 74 years (p = 55% had increased pulse pressure, suggesting a role for arterial stiffening. Treatment differed by EF. Creatinine increased >= 0.5 mg/dl more often in the group with HF and normal EF than in the group with HF and severely decreased EF. In-hospital mortality and length of stay in the intensive care unit varied inversely with EF; overall length of stay was similar. In conclusion, patients with HF and normal EF are more likely to be women, have a history of high pulse pressure hypertension, less coronary artery disease, and a lower risk of inpatient death but a higher likelihood of deterioration in renal function during hospitalization. These observations may be important considerations in the design of future clinical trials. (C) 2008 Elsevier Inc. All rights reserved.